Robotic omentectomy in gynecologic oncology: surgical anatomy, indications, and a technical approach

J Robot Surg. 2023 Aug;17(4):1381-1391. doi: 10.1007/s11701-022-01519-1. Epub 2023 Jan 17.

Abstract

An omentectomy is a standard component care of gynecological cancers, particularly for surgical staging and treatment for malignant ovarian neoplasms, borderline tumors, fallopian tube cancers, primary peritoneal cancers as well as certain histological subtypes of endometrial cancer. Traditionally, an omentectomy is performed by an open laparotomy approach, however, use of a robotic approach has gained popularity and has been proven to be both safe and effective. In spite of the advantages of robotic surgery compared to laparotomy, the inherent technical challenges of a robotic omentectomy may limit its uptake. In this article, we review (1) the physiology and surgical anatomy of the omentum, (2) the role of the omentum in immune regulation and oncogenesis, (3) indications for an omentectomy in the setting of gynecological malignancy, and (4) describe a step-by-step 3-arm technique for performing both a infracolic and gastrocolic omentectomy procedure using a robotic approach.

Keywords: Endometrial cancer; Gynecologic oncology; Minimally invasive; Omentectomy; Ovarian cancer debulking; Robotic.

Publication types

  • Review

MeSH terms

  • Female
  • Genital Neoplasms, Female*
  • Humans
  • Neoplasm Staging
  • Omentum / surgery
  • Ovarian Neoplasms* / pathology
  • Ovarian Neoplasms* / surgery
  • Robotic Surgical Procedures* / methods
  • Robotics*